Shri Kali Ashram Application Form
All students must fill this form out before coming to Shri Kali Ashram.
How many people are you applying for? *
Double option for friends and couples sharing a bedroom.
Which program are you attending? *
Full Name *
Please fill out this personal information below for one person. If you are coming as two people, afterwards you will be asked to answer about the second person.
Your answer
Email *
Your answer
Home Address: *
Your answer
Telephone number: *
Your answer
Passport Number *
Your answer
Age *
Your answer
Country of Origin *
Your answer
How long have you been practicing yoga? *
Please tell us about your primary style, teachers, personal practice, etc.
Your answer
What do you hope to accomplish in this course? *
Your answer
Please describe any health conditions that might affect your yoga. *
Physical and Psychological. Ex. medications, old injuries, psychological issues, medical conditions, etc. Please explain in detail
Your answer
Food details: *
Required
Please if you have any food allergies explain here:
Your answer
Arrival Date: *
Month/Day/Year
MM
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DD
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YYYY
Departure Date: *
Month/Day/Year
MM
/
DD
/
YYYY
Your emergency contact information: *
(Name, phone and e-mail)
Your answer
Which method are you using to pay for the course? *
What’s the total cost of your course (the amount paid by Electronic Deposit or to be paid upon arrival in cash) and the currency used *
If you are paying by credit/debit card (Pay Pal) you don't need to update this info. Just please fill 'Pay Pal'
Your answer
Have you already paid (in case of Card or Electronic Bank Transfer)? *
How did you find out about Shri Kali Ashram? *
If it was by recommendation could you tell us by who?
Your answer
If you are a returning student which program did you attend in the past?
(just for returning students)
When did you attend?
Month/Day/Year (just for returning students)
MM
/
DD
/
YYYY
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